Lurasidone Monotherapy Improves Quality of Life in Bipolar I Depression: Reduced Scores on the MADRS and CGI Seen within 6 Weeks

Article excerpt

AT THE ASCP ANNUAL MEETING

HOLLYWOOD, FLA. -- Lurasidone as monotherapy in the dosage range of either 20-60 mg/day or 80-120 mg/day significantly improved functioning and quality of life in patients with bipolar depression, a post hoc analysis has shown.

In a previously published study of 318 patients randomized to either lurasidone dosage groups or placebo, the drug's association at both dose ranges with reduced Montgomery-Asberg Depression Scale total scores and Clinical Global Impressions scale for bipolar depression severity scores from baseline to week 6 was significant.

The study also noted that both lurasidone groups had significant improvements in patient-reported measures of quality of life and functional impairment, compared with the placebo group (P less than .001 for each) (Am. J. Psychiatry 2014;171:160-8).

The findings led Dr. Terence A. Ketter, who is professor of psychiatry and chief of the bipolar disorders clinic at Stanford (Calif.) University, to wonder how the improvements in functionality and quality of life had happened in such relatively short order.

"It kind of makes sense that it's related to the mood improvement," Dr. Ketter said in an interview during a poster session at a meeting of the American Society of Clinical Psychopharmacology, formerly known as the New Clinical Drug Evaluation Unit meeting.

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To investigate further, Dr. Ketter and his colleagues performed a mediation regression analysis using data from phase III of the original trial. The results were that reduced depressive symptoms from baseline to week 6 mediated the effect of lurasidone on Sheehan Disability Scale functional recovery and Quality of Life Enjoyment and Satisfaction Questionnaire scores at week 6 (P less than .05 for each).

"This suggests that, at least in the first 6 weeks, most of the improvement [in functionality and quality of life] is related to the improvement in depressive symptoms," Dr. Ketter said.

"Functional recovery is something that takes months, and it may be that beyond this by a month or two, you're looking at a degree of mood improvement by duration interaction to get functional improvement."

He added that there likely would be a "huge improvement" in cognition, simply because of the removal of depressive symptoms. …